How much rates vary
Facilitymedian $513 · 10th to 90th $263 to $708Professionalmedian $513 · 10th to 90th $302 to $794
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $630.96 Median $707.95 Typical High $7,943.28 | Facility | None | $630.96 | $707.95 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $524.81 | Professional | None | $239.88 | $371.54 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $263.03 Typical High $371.54 | Facility | None | $147.91 | $263.03 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $794.33 | Professional | None | $323.59 | $467.74 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $912.01 | Professional | None | $602.56 | $758.58 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $602.56 Typical High $954.99 | Facility | None | $398.11 | $602.56 | $954.99 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $707.95 | Professional | None | $281.84 | $416.87 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $588.84 | Facility | None | $323.59 | $524.81 | $588.84 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $691.83 | Facility | None | $218.78 | $323.59 | $691.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $512.86 Typical High $812.83 | Professional | None | $79.43 | $512.86 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $954.99 | Facility | None | $645.65 | $812.83 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $741.31 | Professional | None | $524.81 | $575.44 | $741.31 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $851.14 | Professional | None | $323.59 | $489.78 | $851.14 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $67.61 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $302.00 | Professional | 54 · Surgery only | $251.19 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $186.21 | $186.21 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $74.13 | $74.13 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $302.00 | Professional | 54 · Surgery only | $275.42 | $275.42 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $40.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $288.40 |
Where Oregon sits
The same service costs 6.4 times more in Colorado than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $2,602FL $408
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.